ALCOHOLIC KETOACIDOSIS - CLINICAL COURSE AND LABORATORY RESULTS

Objectives: To review cases of alcoholic ketoacidosis in order to bett er ascertain therapeutic management. Methods: The medical files of 32 alcoholic patients with ketoacidosis hospitalized in the Saint-Pierre general hospital of the Reunion island from January 1, 1991 through 31 August 1994 were analyzed. Results: There were 18 women and 14 men, m ean age 47 gears, The first clinical signs were predominated by digest ive (n = 22) or neurological disorders (n = 10), Acidosis was severe ( mean pH = 7.12) and always associated with a wide anion gap (mean anio n gap = 35), There were 3 types of glycemic status: hypoglycemia 10 ca ses, normal or subnormal glycemia in 19 cases (mean glycemia = 9.3 mmo l/l) and hyperglycemia above 20 mmol/l in 3 cases, Hypophosphatemia, e levated serum lactate levels and cytolytic hepatitis were the main abn ormalities associated. Conclusion: Short-term outcome was favorable in all cases after rehydration. The use of insulin may be dangerous and needs to be avoided.